Anticipated Impact on Veteran's Healthcare: The findings of this study have the potential to improve the quality of clinical care provided to Veteran patients with obstructive sleep apnea who are prescribed CPAP. Project Background: Obstructive sleep apnea (OSA) is highly prevalent in the Veteran population given the risk factors of male gender, being overweight, and increasing age. OSA is caused by upper airway obstruction, resulting in arousals from sleep and hypoxia. While continuous positive airway pressure (CPAP) is a highly efficacious treatment for OSA, compliance with treatment is suboptimal. Because research shows that adherence patterns are established early in treatment, we seek to use a technology that enables early and frequent productive interactions between patient and provider Project Objectives: The objective of this proposal is to explore the feasibility and initially evaluate the potential efficacy of a video teleconferencing system for patients with Obstructive Sleep Apnea syndrome (OSA) that facilitates patient- centered, collaborative management for patients who are prescribed the gold-standard treatment, continuous positive airway pressure (CPAP). Project Methods: The evaluative aspect of this proposal is designed as a pilot randomized, controlled clinical trial-Video Teleconferencing compared to Usual Care. The key feature of the Video Teleconferencing intervention is the use of a telemedicine system that allows for audio/visual conferencing with the patient in their home environment from the start of treatment initialization. The provider is able provide more directed feedback to the patient based on the telemedicine interaction, and the patient benefits from increased contact with the provider. Specific inclusion and exclusion criteria will be used, including, age >18 years;confirmed diagnosis of moderate-severe OSA;being newly prescribed CPAP therapy;having chronic symptoms as noted on screening symptom checklist;and fluency in English. Patients will be recruited from local Sleep Clinics. Patients will be enrolled for a 2-month time period. Groups will be compared on quantitative and qualitative measures.